ALINE THOMAZ SOARES
Projetos de Pesquisa
Unidades Organizacionais
7 resultados
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- Revisão de dois instrumentos clínicos de avaliação para predizer risco de quedas em idosos(2014) ANSAI, Juliana Hotta; GLISOI, Soraia Fernandes das Neves; OLIVEIRA, Tamara de; SOARES, Aline Thomaz; CABRAL, Kelem de Negreiros; SERA, Celisa Tiemi Nakagawa; PASCHOAL, Sérgio Marcio PachecoIntroduction: Fall is a common problem in the elderly and it can reduce their mobility and independence. The use of simple tools to detect risk of falls is essential to prevent and treat such events. However, there is no consensus about the most appropriate tools for each situation. Objective: To review studies about efficacy, sensitivity and specificity of Timed Up and Go Test (TUGT) and Berg Balance Scale (BBS) in order to ascertain which is the most appropriate to predict falls in the elderly. Methods: We performed a literature review from MEDLINE, PubMed, ISI, LILACS and Portal de Periódicos CAPES databases, between 2001 and 2011. Results: We selected 17 different articles about BBS and 20 articles about TUGT. The review showed the two tools can be good predictors of falls. However, the articles differed in definition of fall and faller, type of study, quantity and characteristics of sample and assessment of falls, leading to different results as cutoff scores, sensitivity, specificity and prediction of fall. There is controversy about the ability of tools to predict falls in specific samples, such as active elderly. Conclusion: TUGT and BBS are effective to predict falls, provided they are adapted to each sample. Further studies should be performed using articles with homogeneous methods in order to support comparison of results about the effectiveness of tools.
- Using temporal orientation, category fluency, and word recall for detecting cognitive impairment: the 10-point cognitive screener (10-CS)(2016) APOLINARIO, Daniel; LICHTENTHALER, Daniel Gomes; MAGALDI, Regina Miksian; SOARES, Aline Thomaz; BUSSE, Alexandre Leopold; AMARAL, Jose Renato das Gracas; JACOB-FILHO, Wilson; BRUCKI, Sonia Maria DozziObjectives: A screening strategy composed of three-item temporal orientation and three-word recall has been increasingly used for detecting cognitive impairment. However, the intervening task administered between presentation and recall has varied. We evaluated six brief tasks that could be useful as intervening distractors and possibly provide incremental accuracy: serial subtraction, clock drawing, category fluency, letter fluency, timed visual detection, and digits backwards. Methods: Older adults (n = 230) consecutively referred for suspected cognitive impairment underwent a comprehensive assessment for gold-standard diagnosis, of whom 56 (24%) presented cognitive impairment not dementia and 68 (30%) presented dementia. Among those with dementia, 87% presented very mild or mild stages (Clinical Dementia Rating 0.5 or 1). The incremental value of each candidate intervening task in a model already containing orientation and word recall was assessed. Results: Category fluency (animal naming) presented the highest incremental value among the six candidate intervening tasks. Reclassification analyses revealed a net gain of 12% among cognitively impaired and 17% among normal participants. A four-point scaled score of the animal naming task was added to three-item temporal orientation and three-word recall to compose the 10-point Cognitive Screener. The education-adjusted 10-point Cognitive Screener outperformed the longer Mini-Mental State Examination for detecting both cognitive impairment (area under the curve 0.85 vs 0.77; p = 0.027) and dementia (area under the curve 0.90 vs 0.83; p= 0.015). Conclusions: Based on empirical data, we have developed a brief and easy-to-use screening strategy with higher accuracy and some practical advantages compared with commonly used tools.
- Decreased Brain-Derived Neurotrophic Factor in Older Adults with Bipolar Disorder(2016) SOARES, Aline T.; ANDREAZZA, Ana C.; REJ, Soham; RAJJI, Tarek K.; GILDENGERS, Ariel G.; LAFER, Beny; YOUNG, L. Trevor; MULSANT, Benoit H.Objectives: Decreased levels of brain derived neurotrophic factor (BDNF) have been found in adult patients with bipolar disorder (BD) compared with a comparison group, yet there are no data specifically examining this in geriatric patients. The objective of this study was to examine whether euthymic late-life BD patients have lower BDNF levels than healthy comparators. Design: Cross-sectional study. Setting: Clinics at the University of Pittsburgh and the Centre for Addiction and Mental Health (Toronto). Participants: Older patients with BD (age >= 50 years, N = 118) and similarly aged healthy comparators (N = 76). There were both BD type I (N = 91) and type II (N = 27) patients. Measurements: Serum BDNF levels were assessed in BD patients and healthy comparators. Results: We found lower levels of BDNF in patients with BD than in healthy comparators (9.0 +/- 6.2 versus 12.3 +/- 8.9 pg/mu g, t((192)) = -3.01, p = 0.002), which remained even after controlling for age, sex, lithium use, and site (F-(1,F-176) = 4.32, p = 0.039). This decrease was found specifically in patients with BD type I (8.0 +/- 5.5 versus 12.3 +/- 8.9 pg/mu g, t((165)) = 3.7, Bonferroni p < 0.001), but not type II (12.0 +/- 7.5 versus 12.3 +/- 8.9 pg/mu g, t((101)) = 0.14, Bonferroni p = 1.0). Conclusions: Older patients with BD have lower serum levels of BDNF compared with similarly aged comparators. These effects appear to be specific to patients with BD type I. Future studies are needed to investigate the impact of reduced BDNF levels on cognition, mood, and other aspects of BD throughout the life course.
conferenceObject Decrease Brain-Derived Neurotrophic Factor (BDNF) in Older Patients with Bipolar Disorder(2014) ANDREAZZA, Ana C.; RAJJI, Tarek K.; GILDENGERS, Ari; SOARES, Aline T.; LAFER, Beny; YOUNG, L. Trevor; MULSANT, Benoit H.- CAN WE EXCLUDE DEMENTIA IN OLDER ADULTS WITH SUSPECTED COGNITIVE IMPAIRMENT WHO ATTEND THE CLINICAL ENCOUNTER ALONE?(2014) APOLINARIO, Daniel; SOARES, Aline Thomaz; MAGALDI, Regina Miksian; BUSSE, Alexandre Leopold; BARRETTO-FILHO, Antonio Carlos Pereira; JACOB-FILHO, Wilson
- Effectiveness of a multifactorial falls prevention program in community-dwelling older people when compared to usual care: study protocol for a randomised controlled trial (Prevquedas Brazil)(2013) CABRAL, Kelem de Negreiros; PERRACINI, Monica Rodrigues; SOARES, Aline Thomaz; STEIN, Francine de Cristo; SERA, Celisa Tiemi Nakagawa; TIEDEMANN, Anne; SHERRINGTON, Cathie; JACOB FILHO, Wilson; PASCHOAL, Sergio Marcio PachecoBackground: Falling in older age is a major public health concern due to its costly and disabling consequences. However very few randomised controlled trials (RCTs) have been conducted in developing countries, in which population ageing is expected to be particularly substantial in coming years. This article describes the design of an RCT to evaluate the effectiveness of a multifactorial falls prevention program in reducing the rate of falls in community-dwelling older people. Methods/design: Multicentre parallel-group RCT involving 612 community-dwelling men and women aged 60 years and over, who have fallen at least once in the previous year. Participants will be recruited in multiple settings in Sao Paulo, Brazil and will be randomly allocated to a control group or an intervention group. The usual care control group will undergo a fall risk factor assessment and be referred to their clinicians with the risk assessment report so that individual modifiable risk factors can be managed without any specific guidance. The intervention group will receive a 12-week Multifactorial Falls Prevention Program consisting of: an individualised medical management of modifiable risk factors, a group-based, supervised balance training exercise program plus an unsupervised home-based exercise program, an educational/behavioral intervention. Both groups will receive a leaflet containing general information about fall prevention strategies. Primary outcome measures will be the rate of falls and the proportion of fallers recorded by monthly falls diaries and telephone calls over a 12 month period. Secondary outcomes measures will include risk of falling, fall-related self-efficacy score, measures of balance, mobility and strength, fall-related health services use and independence with daily tasks. Data will be analysed using the intention-to-treat principle. The incidence of falls in the intervention and control groups will be calculated and compared using negative binomial regression analysis. Discussion: This study is the first trial to be conducted in Brazil to evaluate the effectiveness of an intervention to prevent falls. If proven to reduce falls this study has the potential to benefit older adults and assist health care practitioners and policy makers to implement and promote effective falls prevention interventions.
- Characterizing spontaneously reported cognitive complaints: the development and reliability of a classification instrument(2013) APOLINARIO, Daniel; MIRANDA, Rafaela Branco; SUEMOTO, Claudia Kimie; MAGALDI, Regina Miksian; BUSSE, Alexandre Leopold; SOARES, Aline Thomaz; LOPES, Leonardo da Costa; KASAI, Juliana Yumi Tizon; SATOMI, Erika; KIKUCHI, Elina Lika; JACOB-FILHO, WilsonBackground: The characteristics and associated risks of spontaneously reported cognitive complaints have not been investigated due to the lack of a classification instrument. Methods: In phase 1, a classification system with descriptive categories and cognitive domains was developed by experts through a modified Delphi technique. In phase 2, 180 elderly patients seeking medical attention for cognitive complaints provided free reports of their cognitive difficulties and each complaint was recorded verbatim. Three observers were asked to classify each complaint into a descriptive category. Perceived cognitive function was further characterized using the Memory Complaint Questionnaire (MAC-Q). Results: The patients reported 493 spontaneous complaints, with a range of 1-6 complaints per patient and a mean of 2.7 (+/- 1.3). The proportion of complaints that could be classified into a category by each of the three observers varied from 91.9% to 95.7%. Inter-observer agreement assessed using the kappa statistic varied from 0.79 to 1 for descriptive categories and 0.83 to 0.97 for domains. Compared with the MAC-Q, spontaneously reported complaints provided complementary information by avoiding the cueing effect provoked by the questionnaire. The total number of complaints and their occurrences in specific domains were associated with important sociodemographic and clinical factors, indicating that their meaning and associated risks need to be further investigated. Conclusion: The instrument developed in this study proved to be a practical tool for classifying the majority of spontaneously reported cognitive complaints with high reliability. Further studies are needed to investigate clinical usefulness of this approach.